Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma: 10-year results

Breheret M, Lubgan D, Haderlein M, Hecht M, Traxdorf M, Schmidt D, Müller SK, Kitzsteiner C, Kuwert T, Iro H, Fietkau R, Semrau S (2019)

Publication Type: Journal article

Publication year: 2019

Journal

European Archives of Oto-Rhino-Laryngology Springer

DOI: 10.1007/s00405-019-05665-5

Abstract

Introduction The response to induction chemotherapy (IC) predicts local control after conservative treatment of laryngeal, meso- and hypopharyngeal head and neck squamous cell carcinoma (HNSCC) and can thus help to avoid surgery. Single-cycle induction chemotherapy may help to maintain a low local recurrence rate while keeping the overall toxicity manageable. However, long-term data on single-cycle IC response by tumor location is lacking. Methods N = 102 patients with functionally inoperable primary HNSCC of the larynx (n = 43), hypopharynx (n = 42) or mesopharynx/tongue (n = 17) received one cycle of docetaxel (75 mg/m(2), d1) plus cisplatin (30 mg/m(2), d1-3) or carboplatin (AUC 1.5, d1-3) and a response evaluation 3 weeks later. Responders (>= 30% tumor size reduction and >= 20% SUVmax decrease in F-18-FDG PET/CT) were recommended chemoradiotherapy (CRT), and non-responders surgery. Results The overall response rate was 72.5%. All 74 responders and 10 non-responders received primary CRT, and 18 patients received primary surgery after single-cycle IC. Overall 10-year local recurrence-free survival (LRFS) was 73.7%. Three-year LRFS was 88.2% (mesopharynx/tongue), 88.2% (larynx), and 73.3% (hypopharynx); p = 0.17. 3-year distant metastasis-free survival (DMFS) was 94.1% (mesopharynx/tongue), 88.0% (larynx) and 76.4% (hypopharynx); p > 0.05. This influenced the 3-year cancer-specific survival (CSS) for larynx (91.2%) vs. hypopharynx tumors (60.8%); p = 0.003, but CSS was not different to tumors in the mesopharynx/tongue (81.4%); p > 0.05. Conclusions A single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx.

Authors with CRIS profile

Dorota Lubgan Department of Radiation Oncology Marlen Haderlein Department of Radiation Oncology Markus Hecht Department of Radiation Oncology Maximilian Traxdorf Medizinische Fakultät Daniela Schmidt Medizinische Fakultät Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Torsten Kuwert Lehrstuhl für Klinische Nuklearmedizin Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Rainer Fietkau Lehrstuhl für Strahlentherapie Sabine Semrau Medizinische Fakultät

How to cite

APA:

Breheret, M., Lubgan, D., Haderlein, M., Hecht, M., Traxdorf, M., Schmidt, D.,... Semrau, S. (2019). Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma: 10-year results. European Archives of Oto-Rhino-Laryngology. https://doi.org/10.1007/s00405-019-05665-5

MLA:

Breheret, Marius, et al. "Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma: 10-year results." European Archives of Oto-Rhino-Laryngology (2019).

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